Free Markets for Health Care

Here’s an illustration of why one is badly needed.  The Wall Street Journal‘s article is centered on health coverage plans, but the underlying problem is in health care provision and the monopolistic nature of both provision and coverage.

Last year, Cigna Corp and the New York hospital system Northwell Health discussed developing an insurance plan that would offer low-cost coverage by excluding some other health-care providers, according to people with knowledge of the matter. It never happened.
The problem was a separate contract between Cigna and NewYork-Presbyterian, the powerful hospital operator that is a Northwell rival. Cigna couldn’t find a way to work around restrictive language that blocked it from selling any plans that didn’t include NewYork-Presbyterian, according to the people.

A Next Step

A step has been taken to mitigate the destructiveness of Obamacare.  A new rule has been promulgated by the Trump administration that will

allow for the proliferation of cheaper, less-comprehensive health plans that have been restricted by the former Obama administration.

Under the rule, actual health insurance plans will be allowed that cover a range of health-related matters that more closely align with a customer’s interests.  These plans also will be good for a year and be renewable for a total of three years, a drastic improvement over Obamacare’s limit of 90 days.  A further improvement of this rule:

Paying for Health Care

John Cochrane correctly decried the costs of health care in today’s economy, but he has the wrong solution.

Why is paying for health care such a mess in America? Why is it so hard to fix? Cross-subsidies are the original sin.

No, cross-subsidies, “sinful” as they are, are not the original sin.  The original sin is government involvement at all in the form of any sort of subsidy.  Far from the subheadline’s claim that “honest subsidies” (eliding the oxymoronic nature of that label) would encourage competition and innovation, they’d do the opposite, as all subsidies do: they’d suppress competition and innovation by giving the government-favored recipients a government-mandated advantage over their government disfavored competitors, freeing the one from competition’s pressures to innovate and reducing the other’s access to resources needed to innovate—and stifling competition’s engine, the need to innovate to stay ahead of rivals.

AHPs

Association Health Plans are new plans that, by regulation, allow small businesses to band together across industries and state boundaries to form health insurance buying consortiums.  Using this larger size-generated buying power, they should be able to acquire cheaper, better tailored, more flexible plans for their employees, plans that those employees actually will want.

However.

The left says association plans are junk insurance that will blow up ObamaCare.

Some AHPs likely will be; that’s a fact of life in any market, free or centrally planned. However, a free market is self-regulating and quickly so; junk plans will be few and far between.  Blow up Obamacare?  That’s win-win.

Why Should There Be a Cap?

Scott Atlas wrote in a recent Wall Street Journal that all of us should have access to health savings accounts, instead of just the few well-off among us who can afford the high deductible health coverage plan that’s currently a prerequisite for having an HSA.  He also wants to raise the cap for contributing to one to $7,350 per year.

He’s on the right track, but he stopped short.  Why should there be a cap on HSA contributions?  Why can’t we contribute as much or as little as we want instead of what Government will permit?

Another Obamacare Episode

The Justice Department has declined to defend Obamacare in the suit against it brought by a large number of States in the aftermath of Congress’ repeal of the Individual Mandate penalty tax.  Recall that Chief Justice John Roberts rewrote the law in 2012 to recreate the penalty as a tax in order to preserve the IM as constitutional, and thereby to preserve all of Obamacare as constitutional because of the inseverability of all parts of the law.

With the repeal of the IM’s…tax…that inseverability should doom the rest of Obamacare.

As a result of Attorney General Jeff Sessions’ decision not to defend the law,

The Veterans Administration

…won’t clean up after itself.  In this instance, literally.  This is the VA “hospital” room a veteran was placed in when he went to that…facility…for treatment that involved 18 injections.  Injections to be done in a room as filthy as this.

Dr Karen Gribbin, the chief of staff at the George E Wahlen Department of Veteran Affairs Medical Center, on Saturday reportedly said that Wilson should not have been in the room. She said the rooms should be cleaned prior to each patient and called on an investigation.

Wahlen is the imitation hospital at which this failure occurred.  The vetaran’s father, who posted the tweet, also tweeted

An Unintended Consequence

The health coverage plan providers, companies like Humana, Aetna, Anthem, et al., are gaming the Medicare system to keep their Medicare bonuses coming in.  Surprise.

It seems that when Obamacare was passed, it included a system of paying bonuses from Medicare to those plan providers that got sufficiently high ratings on the quality of their plans.

But wait….

Medicare ranks privately managed plans…on a five-star quality scale and provides financial bonuses to providers of top-ranked plans. [A plan-holder’s] plan was set to be downgraded, which would have cost Humana its bonus. So the company merged plans covering [the plan-holder] and more than a million others into different contracts with higher scores. That preserved the bonuses.

A New Insurance Plan

Idaho has one.  Blue Cross of Idaho says it’s going to take advantage of newly issued State regulations to start marketing a plan that won’t meet Obamacare requirements, and they’re going to sell the plan alongside its existing Obamacare-compliant plans.

The Idaho Department of Insurance last month became the first state regulator to say it would let insurers begin offering “state-based plans” for consumers that involved practices generally banned for individual insurance under the ACA, including tying premium rates to enrollees’ pre-existing health conditions.

In particular,

A New Welfare Trap

This one is in the offing at the State level, and comes as a result of the punitive tax for not buying health coverage was repealed last December.

At least nine states are considering their own versions of a requirement that residents must have health insurance….

And

Maryland lawmakers are pursuing a plan to replace the ACA mandate, which requires most people to pay a penalty if they don’t have coverage. California, Connecticut, Hawaii, Minnesota, New Jersey, Rhode Island, Vermont, and Washington, as well as the District of Columbia, are publicly considering similar ideas.